Boyd O
The General Intensive Care Unit, Royal Sussex County Hospital, Brighton, UK.
Intensive Crit Care Nurs. 2003 Jun;19(3):171-81. doi: 10.1016/s0964-3397(03)00026-0.
Surgical patients with limited cardiovascular reserve have much worse prognosis than patients with normal hearts. This review identifies 17 randomised controlled clinical trials that have investigated peri-operative therapy designed to increase tissue perfusion in surgical patients, many of whom have limited cardiovascular reserve. Although there are differences which make equating the trials complex, a total of 1974 patients have been enrolled in the studies and the odds ratio for reduction in mortality is 0.45 (95% confidence intervals 0.33-0.60). Further research needs to be undertaken in the identification of patients with limited cardiovascular reserve and for investigating proposed treatment strategies. Despite this, it appears that such patients have improved outcome if they are admitted to intensive care unit pre-operatively and have suitable therapy given to improve tissue oxygen delivery.
心血管储备功能有限的外科手术患者的预后比心脏正常的患者差得多。本综述确定了17项随机对照临床试验，这些试验研究了旨在增加外科手术患者组织灌注的围手术期治疗，其中许多患者心血管储备功能有限。尽管存在差异使得试验难以等同，但这些研究共纳入了1974例患者，死亡率降低的比值比为0.45（95%置信区间0.33-0.60）。需要进一步开展研究以识别心血管储备功能有限的患者，并研究提出的治疗策略。尽管如此，这类患者如果术前入住重症监护病房并接受适当治疗以改善组织氧输送，似乎预后会有所改善。
